Evaluation of collateral circulation and short-term prognosis of patients with acute cerebral infarction by perfusion-weighted MRI

Abstract

Background: Perfusion-weighted magnetic resonance imaging (MRI) can evaluate collateral circulation in patients with acute cerebral infarction by reflecting hemodynamic signals in the brain. The purpose of this study was to evaluate the collateral circulation and short-term prognosis of patients with acute cerebral infarction, using perfusion-weighted MRI. Methods:The study enrolled 206 patients with acute cerebral infarction due to unilateral cerebral artery occlusion diagnosed by digital subtraction angiography (DSA) and computed tomography angiography (CTA). The relative cerebral blood volume (rCBV), relative cerebral blood flow map (rCBF), relative peak time (rTTP), and relative mean transit time (rMTT) were calculated based on the ratio of the perfusionweighted MRI reference values of the infarcted side and the control side of the patient. According to the results of perfusion-weighted MRI, patients were divided into a high perfusion group (n=121) and a low perfusion group (n=85). The Thrombolysis in Cerebral Infarction scale proposed by Higashida et al. in 2003 (Higashida scale) was used to evaluate the establishment of collateral circulation on the day of admission and 15 days after admission. The National Institutes of Health Stroke Scale (NIHSS) score and the modified Rankin scale assessed the short-term prognosis of patients with cerebral infarction. The Spearman correlation analysis examined the correlation between the rCBV, rCBF, and NIHSS scores, and the modified Rankin scale (mRS).Results: Compared with the patients in the low perfusion group, the rCBV and rCBF in the infarcted area of the patients in the high perfusion group were significantly increased and the rTTP and rMTT were significantly decreased. On day 15 after admission, the collateral circulation rate of the high perfusion group was significantly higher than that of the low perfusion group, and the NIHSS score and the mRS score were significantly lower than those scores of the low perfusion group. Perfusion-weighted MRI indexes, rCBV, and rCBF were negatively correlated with the NIHSS score and Rankin scale.Conclusions: Perfusion-weighted MRI can effectively evaluate the compensatory ability of collateral circulation and the prognosis of patients with acute cerebral infarction.

Meta-Analysis of Prognostic Correlation of Thrombectomy for Cerebral Infarction Based on Intelligent Medical Treatment

“…In this study, the cerebral hemorrhage rate and mortality of the group with good collateral circulation were significantly lower than that of the group with poor collateral circulation, suggesting that good collateral circulation can reduce the risk of death after thrombolytic therapy in patients with cerebral infarction and other cerebrovascular diseases, which is basically consistent with the conclusions of previous studies [9]. The discovery of the cause can make the collateral circulation around cerebral infarction increase regional perfusion and enhance internal and external dissolved suppository in the infarction area transmission capacity, achieving dissolving suppositories evenly distributed to the infarction area and clinical goals, give play to the role of a wide range of thrombolysis and effectively protect the infarction area and reduce the infarction area, and promote patients with ischemic tissue half dark band function recovery.…”

Evaluation of collateral status and outcome in patients with middle cerebral artery stenosis in late time window by CT perfusion imaging

“…Patients with good outcomes had a significantly higher CBV ratio compared with poor outcomes. This finding is in agreement with previous studies ( 34 – 36 ).…”